Accuracy of Magnetic Resonance Imaging in Pretreatment Lymph Node Assessment for Gynecological Malignancies

Objective: To determine the accuracy of magnetic resonance imaging (MRI) in detection of metastasis inpelvic and para-aortic lymph nodes from different gynecological malignancies. Materials and
Methods: Thisretrospective cross sectional analytic study was conducted at the Department of Diagnostic Radiology, AgaKhan University Hospital Karachi Pakistan from January 2011 to December 2012. A sample of 48 women, agerange between 20-79 years, fulfilling inclusion criteria were included. All patients had histopathologically provengynecological malignancies in the cervix, endometrium or ovary and presented for a pretreatment MRI to ourradiology department.
Results: MRI was 100% sensitive and had a 100% positive predictive value to detect lymphnode metastasis in lymph nodes with spiculated margins and 100% sensitive with a 75% positive predictive valueto detect lymph node metastasis in a lymph node with lobulated margins. The sensitivity and positive predictivevalue of MRI to detect heterogeneous nodal enhancement were 100% and 75% respectively.
Conclusions: Ourstudy results reinforce that MRI should be used as a modality of choice in the pretreatment assessment of lymphnodes in proven gynaecological malignancies in order to determine the line of patientmanagement, distinguishingsurgical from non-surgical cases.